Title Loan Contract 12-2003

Title Loan Agreement
Date of Loan: Loan Number:

Name of Lender Certificate Number: Name of Borrower
Street Address Street Address
City, State City, State
Telephone Number Hours of Operation: Date of Birth: Social Security Number:
Description of Titled Personal Property: Year: Make: Model: Type:
VIN#: Color: License Plate #:

Vehicle May Be Delivered To: Date of Loan:
Between the hours of: Monthly Rate of Interest: %
ANNUAL FINANCE Amount Total of

PERCENTAGE CHARGE Financed Payments
RATE The dollar amount the credit will cost The amount of credit provided to you The amount you will have paid after
The cost of your credit as a yearly rate. you. or on your behalf. you have made all payments as
scheduled.
% $ $ $
Number of Payments Amount of Payment When Payments Are Due
Your payment schedule will be:
Security: You are giving a security interest in _____________________________

Late Charge: If this is a single payment loan and a payment is 15 days late you will be charged 5% of the payment, or $50, whichever is less.
If this is a monthly payment loan and a payment is 15 days late you will be charged 5% of the payment, or $50, whichever is less,
subject to a minimum charge of $15 for payments over $25 and $5 for payments of $25 or less.
Prepayment: If you pay off early you will not have to pay a penalty.
See your contract documents for any additional information about nonpayment, default, any required repayment in full before the scheduled date, and prepayment refunds and penalties.
________________________________
e means an estimate.
Itemization of Amount Financed of $________________ NOTICE OF YOUR FINANCIAL PRIVACY RIGHTS

$_____________ Amount given to you directly RESTRICTION OF NON-PUBLIC INFORMATION ACCESS
$_____________ Loan Proceeds paid on your account We restrict access to your non-public personal information to employees needing to
know that information to assist you with products or services. We keep the physical,
$_____________ Amount paid to public officials electronic, and procedural safeguards required by our regulators to insure the safety of
$_____________ Amount paid to others your personal information.
$_____________ Loan Origination Fee INFORMATION TO NON-AFFILIATED THIRD PARTIES
$_(_________) _ Prepaid Finance Charge Since we value our relationship, we will not disclose your non-public personal
information to non-affiliated third parties unless required by law. We also do not
$_____________ Amount Financed disclose non-public personal information about former customers unless required by law.
NOTICE: You may cancel this loan without any costs by returning the full principal balance to the lender by the close of
the lender’s next full business day.
____________________________________________________________________ ____________________________________________________________________________
Borrower Date Borrower Date
Promissory Note
Promise To Pay: The title lender agrees to loan you the principal sum of $_____________, to bear interest at the rate of __________% per annum until paid
in full. The loan is payable in ________ payments of $____________ beginning on _____________ and continuing on the same day of each month thereafter
until paid in full. You may prepay this loan, in full or in part, at any time without penalty. The loan origination fee, if any, is fully earned at the time the loan
is made unless the full principal loan amount is returned to the lender by the close of the next full business day.
Loan Origination Fee: You agree to pay a loan origination fee of $______________.
Security: You agree to give the title lender a security interest per the Uniform Commercial Code in the unencumbered titled personal property listed above
and further agree that the title lender may retain possession of the certificate of title until this loan is paid in full. Upon payment of the loan in full, the lender
will release any security interest in the titled personal property and return the title to you.
Renewals: This loan may be renewed for an additional period of time upon payment of all interest and fees due. Beginning with the 3rd renewal and with
each renewal thereafter, you must reduce the loan by 10% of the original principal amount until the loan is paid in full.
Default: In the event you default on the loan, the lender may, after providing all notices required by law, exercise any and all rights as a secured party per the
Uniform Commercial Code, including repossession of the collateral.
Returned Check Fee: If any instrument is returned for any reason by any financial institution, you agree to pay a fee of $25, plus the amount charged the
title lender by the financial institution for processing the refused instrument.
Late Charge: You also agree to pay a late fee as follows:
If this is a single payment loan and a payment is 15 days late you will be charged 5% of the payment, or $50, whichever is less.
If this is a monthly payment loan and a payment is 15 days late you will be charged 5% of the payment, or $50, subject to a minimum charge
of $15 for payments over $25 and $5 for payments of $25 or less.
Attorney Fees & Court Costs: If it becomes necessary to file suit to collect this loan, you agree to pay attorney fees and court costs pursuant to section
408.140 RSMO.
Nonpayment of this loan may result in the loss of your vehicle, or other titled personal property.
____________________________________ ________________________________________
Title Lender Borrower Date
This lender is regulated by:

Missouri Division of Finance ________________________________________
P O Box 716 Borrower Date
Jefferson City, MO 65102-0716
(573) 751-3463
DO NOT SEND PAYMENTS TO THIS ADDRESS!
(Title Loan 12/03)

Title Loan Contract 12-2003

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Title Loan Contract 12-2003

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Title Loan Agreement

Date of Loan: Loan Number:

VIN#: Color: License Plate #:

Between the hours of: Monthly Rate of Interest: %

ANNUAL FINANCE Amount Total of

Your payment schedule will be:

Security: You are giving a security interest in _____________________________

Itemization of Amount Financed of $________________ NOTICE OF YOUR FINANCIAL PRIVACY RIGHTS

This lender is regulated by:

(Title Loan 12/03)

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